[Results of re-thoracotomy for the management of early postoperative complications after bronchoplastic operations].
We reviewed cases of re-thoracotomy performed for early complications after bronchoplastic procedures. One hundred and sixteen bronchoplasties were performed in our department over 20 years. The diseases for which bronchoplasty was undertaken were lung cancer in 102 patients (87.9%), tuberculous stenosis of the bronchus in eight, esophageal cancer in three, and trauma in three. The most frequent postoperative complication was difficulty of expectoration and atelectasis, which generally improved with conservative treatment. Re-thoracotomy was performed for early postoperative intrathoracic complications on 11 patients. The reasons for re-thoracotomy were bronchial anastomotic dehiscence in five cases, obstruction of bronchial anastomosis in two, atelectasis in two, and occlusion of anastomosis of pulmonary arterial angioplasty in two cases. All except two underwent re-thoracotomy within two weeks of the first operations. The operative procedures performed were completion pneumonectomy in six cases, re-bronchoplasty in three, suture of anastomotic dehiscence in two, patch closure of pericardial defect with aspiration of secretions in the atelectatic lobe in one, and partial decortication with suture closure of the alveolar fistula in one. Pedicled omental wrapping was applied to two patients with re-bronchoplasty and one with completion pneumonectomy. Post-operative complications after re-thoracotomy were anastomotic insufficiency in two cases, bronchopleural fistula in two, and pneumonia in one. Two patients underwent a third thoracotomy. There was no anastomotic dehiscence or bronchopleural fistula in the patients with pedicled omental wrapping. One patient died due to bronchopleural fistula within 30 days of re-thoracotomy. Six patients died of recurrence or pneumonia from 39 days to one year after re-thoracotomy.(ABSTRACT TRUNCATED AT 250 WORDS)
Ayabe
H
H
First Department of Surgery, Nagasaki University School of Medicine, Japan.
Tsuji
H
H
Oka
T
T
Hara
S
S
Chia-Ming
S
S
Tagawa
Y
Y
Kawahara
K
K
Tomita
M
M
D001980:Bronchi / Q000601:surgery*; D001982:Bronchial Diseases / Q000601:surgery; D004938:Esophageal Neoplasms / Q000601:surgery; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D011379:Prognosis; D012086:Reoperation; D013529:Surgical Wound Dehiscence / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods